Aerosols for the delivery of therapeutic agents to the respiratory tract have been described, for example, Adjei, A. and Garren, J., Pharm. Res., 7: 565-569 (1990); and Zanen, P. and Lamm, J.-W. J. Int. J. Pharm., 114: 111-115 (1995). The respiratory tract encompasses the upper airways, including the oropharynx and larynx, followed by the lower airways, which include the trachea followed by bifurcations into the bronchi and bronchioli. The upper and lower airways are called the conducting airways. The terminal bronchioli then divide into respiratory bronchioli which then lead to the ultimate respiratory zone, the alveoli, or deep lung. Gonda, I. xe2x80x9cAerosols for delivery of therapeutic and diagnostic agents to the respiratory tract,xe2x80x9d in Critical Reviews in Therapeutic Drug Carrier Systems, 6: 273-313 (1990). The deep lung, or alveoli, are the primary target of inhaled therapeutic aerosols for systemic drug delivery.
Inhaled aerosols have been used for the treatment of local lung disorders including asthma and cystic fibrosis (Anderson, Am. Rev. Respir. Dis., 140: 1317-1324 (1989)) and have potential for the systemic delivery of peptides and proteins as well (Patton and Platz, Advanced Drug Delivery Reviews, 8: 179-196 (1992)). However, pulmonary drug delivery strategies present many difficulties for the delivery of macromolecules; these include protein denaturation during aerosolization, excessive loss of inhaled drug in the oropharyngeal cavity (often exceeding 80%), poor control over the site of deposition, lack of reproducibility of therapeutic results owing to variations in breathing patterns, the frequent too-rapid absorption of drug potentially resulting in local toxic effects, and phagocytosis by lung macrophages.
Considerable attention has been devoted to the design of therapeutic aerosol inhalers to improve the efficiency of inhalation therapies. Timsina et. al., Int. J. Pharm., 101: 1-13 (1995); and Tansey, I. P., Spray Technol. Market, 4: 26-29 (1994). Attention has also been given to the design of dry powder aerosol surface texture, regarding particularly the need to avoid particle aggregation, a phenomenon which considerably diminishes the efficiency of inhalation therapies. French, D. L., Edwards, D. A. and Niven, R. W., J. Aerosol Sci., 27: 769-783 (1996). Dry powder formulations (xe2x80x9cDPFsxe2x80x9d) with large particle size have improved flowability characteristics, such as less aggregation (Visser, J., Powder. Technology 58: 1-10 (1989)), easier aerosolization, and potentially less phagocytosis. Rudt, S. and R. H. Muller, J. Controlled Release, 22: 263-272 (1992); Tabata, Y. and Y. Ikada, J. Biomed. Mater. Res., 22: 837-858 (1988). Dry powder aerosols for inhalation therapy are generally produced with mean geometric diameters primarily in the range of less than 5 xcexcm. Ganderton, D., J. Biopharmaceutical Sciences, 3: 101-105 (1992); and Gonda, I. xe2x80x9cPhysico-Chemical Principles in Aerosol Delivery,xe2x80x9d in Topics in Pharmaceutical Sciences 1991, Crommelin, D. J. and Midha, K. K., Eds., Medpharm Scientific Publishers, Stuttgart, pp. 95-115, 1992. Large xe2x80x9ccarrierxe2x80x9d particles (containing no drug) have been co-delivered with therapeutic aerosols to aid in achieving efficient aerosolization among other possible benefits. French, D. L., Edwards, D. A. and Niven, R. W., J. Aerosol Sci., 27: 769-783 (1996).
The human lungs can remove or rapidly degrade hydrolytically cleavable deposited aerosols over periods ranging from minutes to hours. In the upper airways, ciliated epithelia contribute to the xe2x80x9cmucociliary escalatorxe2x80x9d by which particles are swept from the airways toward the mouth. Pavia, D. xe2x80x9cLung Mucociliary Clearance,xe2x80x9d in Aerosols and the Lung: Clinical and Experimental Aspects, Clarke, S. W. and Pavia, D., Eds., Butterworths, London, 1984. Anderson, Am. Rev. Respir. Dis., 140: 1317-1324 (1989). In the deep lungs, alveolar macrophages are capable of phagocytosing particles soon after their deposition. Warheit, M. B. and Hartsky, M. A., Microscopy Res. Tech., 26: 412-422 (1993); Brain, J. D., xe2x80x9cPhysiology and Pathophysiology of Pulmonary Macrophages,xe2x80x9d in The Reticuloendothelial System, Reichard, S. M. and Filkins, J., Eds., Plenum, New York, pp. 315-327, 1985; Dorries, A. M. and Valberg, P. A., Am. Rev. Resp. Disease 146: 831-837 (1991); and Gehr, P., Microscopy Res. and Tech., 26: 423-436 (1993). As the diameter of particles exceeds 3 xcexcm, there is increasingly less phagocytosis by macrophages. Kawaguchi, H., Biomaterials 7: 61-66 (1986); Krenis, L. J. and Strauss, B., Proc. Soc. Exp. Med., 107: 748-750 (1961); and Rudt, S. and Muller, R. H., J. Contr. Rel., 22: 263-272 (1992). However, increasing the particle size also has been found to minimize the probability of particles (possessing standard mass density) entering the airways and acini due to excessive deposition in the oropharyngeal or nasal regions. Heyder, J., J. Aerosol Sci., 17: 811-825 (1986).
Local and systemic inhalation therapies can often benefit from a relatively slow controlled release of the therapeutic agent. Gonda, I., xe2x80x9cPhysico-chemical principles in aerosol delivery,xe2x80x9d in: Topics in Pharmaceutical Sciences 1991, D. J. A. Crommelin and K. K. Midha, Eds., Stuttgart: Medpharm Scientific Publishers, pp. 95-117 (1992). Slow release from a therapeutic aerosol can prolong the residence of an administered drug in the airways or acini, and diminish the rate of drug appearance in the bloodstream. Also, patient compliance is increased by reducing the frequency of dosing. Langer, R., Science, 249: 1527-1533 (1990); and Gonda, I., xe2x80x9cAerosols for delivery of therapeutic and diagnostic agents to the respiratory tract,xe2x80x9d in Critical Reviews in Therapeutic Drug Carrier Systems 6: 273-313 (1990).
Controlled release drug delivery to the lung may simplify the way in which many drugs are taken. Gonda, I., Adv. Drug Del. Rev., 5: 1-9 (1990); and Zeng, X., et al., Int. J. Pharm., 124: 149-164 (1995). Pulmonary drug delivery is an attractive alternative to oral, transdermal, and parenteral administration because self-administration is simple, the lungs provide a large mucosal surface for drug absorption, there is no first-pass liver effect of absorbed drugs, and there is reduced enzymatic activity and pH mediated drug degradation compared with the oral route. Relatively high bioavailability of many molecules, including macromolecules, can be achieved via inhalation. Wall, D. A., Drug Delivery, 2: 1-20 1995); Patton, J. and Platz, R., Adv. Drug Del. Rev., 8: 179-196 (1992); and Byron, P., Adv. Drug, Del. Rev., 5: 107-132 (1990). As a result, several aerosol formulations of therapeutic drugs are in use or are being tested for delivery to the lung. Patton, J. S., et al., J. Controlled Release, 28: 79-85 (1994); Damms, B. and Bains, W., Nature Biotechnology (1996); Niven, R. W., et al., Pharm. Res., 12(9): 1343-1349 (1995); and Kobayashi, S., et al., Pharm. Res., 13(1): 80-83 (1996).
Drugs currently administered by inhalation come primarily as liquid aerosol formulations. However, many drugs and excipients, especially proteins, peptides (Liu, R., et al., Biotechnol. Bioeng., 37: 177-184 (1991)), and biodegradable carriers such as poly(lactide-co-glycolides) (PLGA), are unstable in aqueous environments for extended periods of time. This can make storage as a liquid formulation problematic. In addition, protein denaturation can occur during aerosolization with liquid formulations. Mumenthaler, M., et al., Pharm. Res., 11: 12-20 (1994). Considering these and other limitations, dry powder formulations (DPF""s) are gaining increased interest as aerosol formulations for pulmonary delivery. Damms, B. and Bains, W., Nature Biotechnology (1996); Kobayashi, S., et al., Pharm. Res., 13(1): 80-83 (1996); and Timsina, M., et al., Int. J. Pharm., 101: 1-13 (1994). However, among the disadvantages of DPF""s is that powders of ultrafine particulates usually have poor flowability and aerosolization properties, leading to relatively low respirable fractions of aerosol, which are the fractions of inhaled aerosol that escape deposition in the mouth and throat. Gonda, I., in Topics in Pharmaceutical Sciences 1991, D. Cromnielin and K. Midha, Editors, Stuttgart: Medpharm Scientific Publishers, 95-117 (1992). A primary concern with many aerosols is particulate aggregation caused by particle-particle interactions, such as hydrophobic, electrostatic, and capillary interactions. An effective dry-powder inhalation therapy for both short and long term release of therapeutics, either for local or systemic delivery, requires a powder that displays minimum aggregation, as well as a means of avoiding or suspending the lung""s natural clearance mechanisms until drugs have been effectively delivered.
Therefore, a need exists for dry-powders suitable for inhalation which minimize or eliminate the above-mentioned problems.
The invention relates to particles having a tap density of less than about 0.4 g/cm3 and preferably less than about 0.1 g/cm3. The particles include a carboxylate group or moiety. The particles further include a multivalent salt or its ionic components. In one embodiment of the invention, the particles further include a phospholipid. In addition, the particles can include a therapeutic, prophylactic or diagnostic agent or any combination thereof. In one embodiment, the particles have a median geometric diameter of between about 5 microns (xcexcm) and about 30 xcexcm, preferably at least about 9 xcexcm. In another embodiment, the particles have an aerodynamic diameter of between about 1 xcexcm and about 5 xcexcm.
The invention also relates to a method of producing particles having a tap density of less than about 0.4 g/cm3. The method includes forming a mixture which includes a carboxylate moiety, such as provided, for example, by a carboxylic acid or salt thereof, a multivalent salt, a phospholipid, and a solvent. The mixture can also include a therapeutic, prophylactic or diagnostic agent, or any combination thereof. The mixture is spray-dried to form particles having a tap density of less than about 0.4 g/cm3. Preferred solvents that can be employed in the spray drying process include organic or organic-aqueous solvents. In a preferred embodiment, the mixture fed to the spray drying apparatus is a colloidal suspension.
The invention further relates to a method of delivering a therapeutic, prophylactic or diagnostic agent to the pulmonary system of a patient in need of treatment, prophylaxis or diagnosis. The method includes administering to the respiratory tract of the patient an effective amount of particles having a tap density of less than about 0.4 g/cm3 and preferably less than about 0.1 g/cm3. The particles include a therapeutic, prophylactic or diagnostic agent, or any combination thereof and a carboxylate moiety. The particles further include a multivalent salt or its ionic components. In one embodiment of the invention, the particles also include a phospholipid. Delivery to the respiratory system can be primarily to the deep lung, to the central airways or to the upper airways.
The invention relates also to a composition for delivery to a patient in need of treatment, prophylaxis or diagnosis. The composition includes particles which have a tap density of less than about 0.4 g/cm3 and preferably less than about 0.1 g/cm3. In one embodiment, the particles include a carboxylate moiety, a multivalent salt and a phospholipid. In a preferred embodiment, the particles also include a therapeutic, prophylactic or diagnostic agent. In another preferred embodiment, delivery is to the pulmonary system.
In a preferred embodiment, the carboxylate moiety is a hydrophilic carboxylic acid or salt thereof. In another embodiment, preferred carboxylate moieties include at least two carboxyl groups.
In a preferred embodiment, the salt is a divalent salt. Suitable divalent salts include, for example chlorides of alkaline earth metals. Calcium chloride (CaCl2) is preferred. In another preferred embodiment, the multivalent salt is a pharmaceutically acceptable salt.
Preferred phospholipids include but are not limited to phosphatidic acid, phosphatidylcholines, phosphatidylethanolamines, phosphatidylglycerols, phosphatidylserines, phosphatidylinositols and combinations thereof.
The invention has several advantages. Pulmonary delivery advantageously can reduce or eliminate the need for injection. For example, the requirement for daily insulin injections can be avoided. Furthermore, the particles of the invention can be delivered as a dry powder to the deep lung, upper or central airways. They can be used to provide controlled systemic or local delivery of therapeutic or diagnostic agents to the respiratory tract via aerosolization. The particles can be easily prepared from simple, lung-compatible compounds without requiring the use of large macromolecules such as polymers, proteins, polysaccharides and others. The formation of colloidal suspensions results in particles of desired shape and porosity. Compared to methods that require solubilizing, higher concentrations can be employed. Administration of the particles to the lung by aerosolization permits deep lung delivery of relatively large diameter therapeutic aerosols, for example, greater than about 5 xcexcm in mean diameter. The particles can be fabricated with a rough surface texture to reduce particle agglomeration and improve flowability of the powder. The spray-dried particle can be fabricated with features which enhance aerosolization via dry powder inhaler devices, and lead to lower deposition in the mouth, throat and inhaler device.
The features and other details of the invention, either as steps of the invention or as combination of parts of the invention, will now be more particularly described and pointed out in the claims. It will be understood that the particular embodiments of the invention are shown by way of illustration and not as limitations of the invention. The principle feature of this invention may be employed in various embodiments without departing from the scope of the invention.
The invention is directed to particles having a tap density of less than about 0.4 g/cm3 and preferably less than about 0.1 g/cm3 and to methods of producing such particles. The particles can be employed for delivery of a therapeutic, prophylactic or diagnostic agent to a patient in need of therapy, prophylaxis or diagnosis. In a preferred embodiment, delivery is to the pulmonary system. The particles can also be delivered to nonhuman mammals such as, for example, to laboratory animals or in veterinary medicine.
The particles include a carboxylate moiety. In one embodiment of the invention, the carboxylate moiety includes at least two carboxyl groups. Carboxylate moieties can be provided by carboxylic acids, salts thereof as well as by combinations of two or more carboxylic acids and/or salts thereof. In a preferred embodiment, the carboxylate moiety is a hydrophilic carboxylic acid or salt thereof. Suitable carboxylic acids include but are not limited to hydroxydicarboxylic acids, hydroxytricarboxilic acids and the like. Citric acid and citrates, such as, for example sodium citrate, are preferred. Combinations or mixtures of carboxylic acids and/or their salts also can be employed.
The carboxylate moiety can be present in the particles in an amount ranging from about 10 to about 80% weight. Preferably, the carboxylate moiety can be present in the particles in an amount 10-20%.
The particles also include a multivalent salt or its ionic components. As used herein, a xe2x80x9cmultivalentxe2x80x9d salt includes divalent salts. In a preferred embodiment, the salt is a divalent salt. In another preferred embodiment, the salt is a salt of an alkaline-earth metal, such as, for example, calcium chloride. The particles of the invention can also include mixtures or combinations of salts and/or their ionic components.
The salt or its ionic components are present in the particles in an amount ranging from about 5 to about 40% weight.
The particles further include a phospholipid, also referred to herein as phosphoglyceride. In a preferred embodiment, the phospholipid, is endogenous to the lung. In another preferred embodiment the phospholipid includes, among others, phosphatidic acid, phosphatidylcholines, phosphatidylethanolamines, phosphatidylglycerols, phophatidylserines, phosphatidylinositols and combinations thereof. Specific examples of phospholipids include but are not limited to phosphatidylcholines dipalmitoyl phosphatidylcholine (DPPC), dipalmitoyl phosphatidylethanolamine (DPPE), distearoyl phosphatidylcholine (DSPC), dipalmitoyl phosphatidyl glycerol (DPPG) or any combination thereof.
The phospholipid can be present in the particles in an amount ranging from about 20 to about 90% weight. Preferably, it can be present in the particles in an amount ranging from about 50 to about 80% weight.
Suitable methods of preparing and administering particles which include phospholipids, are described in U.S. Pat. No. 5,855,913, issued on Jan. 5, 1999 to Hanes et al. and in U.S. Pat. No. 5,985,309, issued on Nov. 16, 1999 to Edwards et al. The teachings of both are incorporated herein by reference in their entirety.
In another embodiment of the invention the particles include a surfactant such as, but not limited to the phospholipids described above. Other surfactants, such as, for example, hexadecanol; fatty alcohols such as polyethylene glycol (PEG); polyoxyethylene-9-lauryl ether; a surface active fatty acid, such as palmitic acid or oleic acid; glycocholate; surfactin; a poloxomer; a sorbitan fatty acid ester such as sorbitan trioleate (Span 85); tyloxapol can also be employed.
As used herein, the tern xe2x80x9csurfactantxe2x80x9d refers to any agent which preferentially absorbs to an interface between two inmmiscible phases, such as the interface between water and an organic polymer solution, a water/air interface or organic solvent/air interface. Surfactants generally possess a hydrophilic moiety and a lipophilic moiety, such that, upon absorbing to microparticles, they tend to present moieties to the external environment that do not attract similarly-coated particles, thus reducing particle agglomeration. Surfactants may also promote absorption of a therapeutic or diagnostic agent and increase bioavailability of the agent.
The surfactant can be present in the particles in an amount ranging from about 20 to about 90. Preferably, it can be present in the particles in an amount ranging from about 50 to about 80.
Examples of therapeutic, prophylactic or diagnostic agents, also referred to herein as xe2x80x9cbioactive agentsxe2x80x9d, xe2x80x9cdrugsxe2x80x9d or xe2x80x9cmedicamentsxe2x80x9d, both locally as well as systemically acting agents. The particles can also include mixtures of therapeutic, prophylactic and/or diagnostic agents. Furthermore, the particles can include needed biological compounds such as, for example, blood, plasma or oxygen. The particles can include hydrophilic as well as hydrophobic drugs.
Examples of therapeutic, prophylactic or diagnostic agents include, but are not limited to synthetic inorganic and organic compounds, proteins, peptides, polypeptides, polysaccharides and other sugars, lipids, and DNA and RNA nucleic acid sequences having therapeutic, prophylactic or diagnostic activities. Nucleic acid sequences include genes, antisense molecules which bind to complementary DNA or RNA and inhibit transcription, and ribozymes. Polysaccharides, such as heparin, can also be administered. The agents to be incorporated can have a variety of biological activities, such as vasoactive agents, neuroactive agents, hormones, anticoagulants, immunomodulating agents, cytotoxic agents, prophylactic agents, antibiotics, antivirals, antisense, antigens, and antibodies. In some instances, the proteins may be antibodies or antigens which otherwise would have to be administered by injection to elicit an appropriate response. Compounds with a wide range of molecular weight can be encapsulated, for example, between 100 and 500,000 grams or more per mole.
Proteins are defined as consisting of 100 amino acid residues or more; peptides are less than 100 amino acid residues. Unless otherwise stated, the term protein refers to both proteins and peptides. Examples include insulin and other hormones.
Those therapeutic agents which are charged, such as most of the proteins, including insulin, can be administered as a complex between the charged therapeutic agent and a molecule of opposite charge. Preferably, the molecule of opposite charge is a charged lipid or an oppositely charged protein.
The particles can include a therapeutic agent for local delivery within the lung, such as agents for the treatment of asthma, chronic obstructive pulmonary disease (COPD), emphysema, or cystic fibrosis, or for systemic treatment. For example, genes for the treatment of diseases such as cystic fibrosis can be administered, as can beta agonists, steroids, anticholinergies, and leukotriene modifers for asthma. Other specific therapeutic agents include, but are not limited to, human growth hormone, insulin, calcitonin, gonadotropin-releasing hormone (xe2x80x9cLHRHxe2x80x9d), granulocyte colony-stimulating factor (xe2x80x9cG-CSFxe2x80x9d), parathyroid hormone-related peptide, somatostatin, testosterone, progesterone, estradiol, nicotine, fentanyl, norethisterone, clonidine, scopolamine, salicylate, cromolyn sodium, salmeterol, formeterol, albuterol, and Valium.
The particles can include any of a variety of diagnostic agents to locally or systemically deliver the agents following administration to a patient.
Diagnostic agents also include but are not limited to imaging agents which include commercially available agents used in positron emission tomography (PET), computer assisted tomography (CAT), single photon emission computerized tomography, x-ray, fluoroscopy, and magnetic resonance imaging (MRI).
Examples of suitable materials for use as contrast agents in MRI include but are not limited to the gadolinium chelates currently available, such as diethylene triamine pentacetic acid (IDTPA) and gadopentotate dimeglumine, as well as iron, magnesium, manganese, copper and chromium.
Examples of materials useful for CAT and x-rays include iodine based materials for intravenous administration, such as ionic monomers typified by diatrizoate and iothalamate, non-ionic monomers such as iopamidol, isohexol, and ioversol, non-ionic dimers, such as iotrol and iodixanol, and ionic dimers, for example, ioxagalte.
Preferably, a therapeutic agent can be present in the spray-dried particles in an amount ranging from less than about 1% to about 40%. Preferably, a prophylactic agent can be present in the spray-dried particles in an amount ranging from about less than about 1% to about 40%. Preferably, a diagnostic agent can be present in the spray-dried particles in an amount ranging from about less than about 1% to about 40%.
In one embodiment of the invention, the phospholipid or combination or phospholipids present in the particles can have a therapeutic, prophylactic or diagnostic role. For example, the particles of the invention can be used to deliver surfactants to the lung of a patient. This is particularly useful in medical indications which require supplementing or replacing endogenous lung surfactants, for example in the case of infant respiratory distress syndrome.
The particles can include other materials. In one embodiment of the invention, the particles also include an amino acid. Hydrophobic amino acids are preferred. Suitable amino acids include naturally occurring and non-naturally occurring hydrophobic amino acids. Some suitable naturally occurring hydrophobic amino acids, include but are not limited to, leucine, isoleucine, alanine, valine, phenylalanine, glycine and tryptophan. Combinations of hydrophobic amino acids can also be employed Non-naturally occurring amino acids include, for example, beta-amino acids. Both D and L configurations and racemic mixtures of hydrophobic amino acids can be employed. Suitable hydrophobic amino acids can also include amino acid derivatives or analogs. As used herein, an amino acid analog includes the D or L configuration of an amino acid having the following formula: xe2x80x94NHxe2x80x94CHRxe2x80x94COxe2x80x94, wherein R is an aliphatic group, a substituted aliphatic group, a benzyl group, a substituted benzyl group, an aromatic group or a substituted aromatic group and wherein R does not correspond to the side chain of a naturally-occurring amino acid. As used herein, aliphatic groups include straight chained, branched or cyclic C1-C8 hydrocarbons which are completely saturated, which contain one or two heteroatomns such as nitrogen, oxygen or sulfur and/or which contain one or more units of unsaturation. Aromatic groups include carbocyclic aromatic groups such as phenyl and naphthyl and heterocyclic aromatic groups such as imidazolyl, indolyl, thienyl, furanyl, pyridyl, pyranyl, oxazolyl, benzothienyl, benzofuranyl, quinolinyl, isoquinolinyl and acridintyl.
Suitable substituents on an aliphatic, aromatic or benzyl group include xe2x80x94OH, halogen (xe2x80x94Br, xe2x80x94Cl, xe2x80x94I and xe2x80x94F) xe2x80x94O(aliphatic, substituted aliphatic, benzyl, substituted benzyl, aryl or substituted aryl group), xe2x80x94CN, xe2x80x94NO2, xe2x80x94COOH, xe2x80x94NH2, xe2x80x94NH(aliphatic group, substituted aliphatic, benzyl, substituted benzyl, aryl or substituted aryl group), xe2x80x94N(aliphatic group, substituted aliphatic, benzyl, substituted benzyl, aryl or substituted aryl group)2, xe2x80x94COO(aliphatic group, substituted aliphatic, benzyl, substituted benzyl, aryl or substituted aryl group), xe2x80x94CONH2, xe2x80x94CONH(aliphatic, substituted aliphatic group, benzyl, substituted benzyl, aryl or substituted aryl group)), xe2x80x94SH, xe2x80x94S(aliphatic, substituted aliphatic, benzyl, substituted benzyl, aromatic or substituted aromatic group) and xe2x80x94NHxe2x80x94C(xe2x95x90NH)xe2x80x94H2. A substituted benzylic or aromatic group can also have an aliphatic or substituted aliphatic group as a substituent. A substituted aliphatic group can also have a benzyl, substituted benzyl, aryl or substituted aryl group as a substituent. A substituted aliphatic, substituted aromatic or substituted benzyl group can have one or more substituents. Modifying an amino acid substituent can increase, for example, the lypophilicity or hydrophobicity of natural amino acids which are hydrophilic.
A number of the suitable amino acids, amino acids analogs and salts thereof can be obtained commercially. Others can be synthesized by methods known in the art. Synthetic techniques are described, for example, in Green and Wuts, xe2x80x9cProtecting Groups in Organic Synthesisxe2x80x9d, John Wiley and Sons, Chapters 5 and 7, 1991.
Hydrophobicity is generally defined with respect to the partition of an amino acid between a nonpolar solvent and water. Hydrophobic amino acids are those acids which show a preference for the nonpolar solvent. Relative hydrophobicity of amino acids can be expressed on a hydrophobicity scale on which glycine has the value 0.5. On such a scale, amino acids which have a preference for water have values below 0.5 and those that have a preference for nonpolar solvents have a value above 0.5. As used herein, the term hydrophobic amino acid refers to an amino acid that, on the hydrophobicity scale has a value greater or equal to 0.5, in other words, has a tendency to partition in the nonpolar acid which is at least equal to that of glycine.
Examples of amino acids which can be employed include, but are not limited to: glycine, proline, alanine, cysteine, methionine, valine, leucine, tyrosine, isoleucine, phenylalanine, tryptophan. Preferred hydrophobic amino acids include leucine, isoleucine, alanine, valine, phenylalanine, glycine and tryptophan. Combinations of hydrophobic amino acids can also be employed. Furthermore, combinations of hydrophobic and hydrophilic (preferentially partitioning in water) amino acids, where the overall combination is hydrophobic, can also be employed. Combinations of one or more amino acids and one or more phospholipids or surfactants can also be employed. Materials which impart fast release kinetics to the medicanent are preferred.
The amino acid can be present in the particles of the invention in an amount of about 60 weight %. Preferably, the amino acid can be present in the particles in an amount ranging from about 5 to about 30 weight %. The salt of a hydrophobic amino acid can be present in the particles of the invention in an amount of about 60 weight %. Preferably, the amino acid salt is present in the particles in an amount ranging from about 5 to about 30 weight %. Methods of forming and delivering particles which include an amino acid are described in U.S. patent application Ser. No. 09/382,959, filed on Aug. 25, 1999, entitled Use of Simple Amino Acids to Form Porous Particles During Spray Drying, and U.S. Patent Application filed concurrently herewith and entitled Use of Simple Amino Acids to Form Porous Particles; the teachings of both are incorporated herein by reference in their entirety.
The particles of the invention can have desired drug release properties. In one embodiment, the particles include one or more phospholipids selected according to their transition temperature. For example, by administering particles which include a phospholipid or combination of phospholipids which have a phase transition temperature higher than the patient""s body temperature, the release of the therapeutic, prophylactic or diagnostic agent can be slowed down. On the other hand, rapid release can be obtained by including in the particles phospholipids having low transition temperatures. Particles having controlled release properties and methods of modulating release of a biologically active agent are described in U.S Provisional Application No. 60/150,742, entitled Modulation of Release From Dry Powder Formulations by Controlling Matrix Transition, filed on Aug. 25, 1999 and U.S. Patent Application filed concurrently herewith, entitled Modulation of Release From Dry Powder Formulations; the contents of both are incorporated herein by reference in their entirety.
Particles, and in particular particles having controlled or sustained release properties, also can include other materials. For example, the spray-dried particles can include a biocompatible, and preferably biodegradable polymer, copolymer, or blend. Such polymers are described, for example, in U.S. Pat. No. 5,874,064, issued on Feb. 23, 1999 to Edwards et al., the teachings of which are incorporated herein by reference in their entirety. Preferred polymers are those which are capable of forming aerodynamically light particles having a tap density less than about 0.4 g/cm3, a mean diameter between about 5 xcexcm and about 30 xcexcm and an aerodynamic diameter between approximately one and five microns, preferably between one and three microns. The polymers can be tailored to optimize different characteristics of the particle including: i) interactions between the agent to be delivered and the polymer to provide stabilization of the agent and retention of activity upon delivery; ii) rate of polymer degradation and, thereby, rate of drug release profiles; iii) surface characteristics and targeting capabilities via chemical modification; and iv) particle porosity.
Surface eroding polymers such as polyanhydrides can be used to form the particles. For example, polyanhydrides such as poly[(p-carboxyphenoxy)-hexane anhydride] (PCPH) may be used. Suitable biodegradable polyanhydrides are described in U.S. Pat. No. 4,857,311.
In another embodiment, bulk eroding polymers such as those based on polyesters including poly(hydroxy acids) can be used. For example, polyglycolic acid (PGA), polylactic acid (PLA), or copolymers thereof may be used to form the particles. The polyester may also have a charged or functionalizable group, such as an amino acid. In a preferred embodiment, particles with controlled release properties can be formed of poly(D,L-lactic acid) and/or poly(D,L-lactic-co-glycolic acid) (xe2x80x9cPLGAxe2x80x9d) which incorporate a surfactant such as DPPC.
Still other polymers include but are not limited to polyamides, polycarbonates, polyalkylenes such as polyethylene, polypropylene, poly(ethylene glycol), poly(ethylene oxide), poly(ethylene terephthalate), poly vinyl compounds such as polyvinyl alcohols, polyvinyl ethers, and polyvinyl esters, polymers of acrylic and methacrylic acids, celluloses and other polysaccharides, and peptides or proteins, or copolymers or blends thereof. Polymers may be selected with or modified to have the appropriate stability and degradation rates in vivo for different controlled drug delivery applications.
In one embodiment, the particles include functionalized polyester graft copolymers, as described in Hrkach et al., Macromolecules, 28: 4736-4739 (1995); and Hrkach et al., xe2x80x9cPoly(L-Lactic acid-co-amino acid) Graft Copolymers: A Class of Functional Biodegradable Biomaterialsxe2x80x9d in Hydrogels and Biodegradable Polymers for Bioapplications, ACS Symposium Series No. 627, Raphael M. Ottenbrite et al., Eds., American Chemical Society, Chapter 8, pp. 93-101, 1996.
The particles can also include other materials such as, for example, buffer salts, dextran, polysaccharides, lactose, trehalose, cyclodextrins, proteins, peptides, olypeptides, fatty acids, inorganic compounds, phosphates.
In a preferred embodiment, the particles of the invention have a tap density less than about 0.4 g/cm3. Particles which have a tap density of less than about 0.4 g/cm3 are referred herein as xe2x80x9caerodynamically light particlesxe2x80x9d. More preferred are particles having a tap density less than about 0.1 g/cm3. Tap density can be measured by using instruments known to those skilled in the art such as the Dual Platform Microprocessor Controlled Tap Density Tester (Vankel, N.C.) or a GeoPyc(trademark) instrument (Micrometrics Instrument Corp., Norcross, Ga. 30093). Tap density is a standard measure of the envelope mass density. Tap density can be determined using the method of USP Bulk Density and Tapped Density, United States Pharmacopia convention, Rockville, Md., 10th Supplement, 4950-4951, 1999. Features which can contribute to low tap density include irregular surface texture and porous structure.
The envelope mass density of an isotropic particle is defined as the mass of the particle divided by the minimum sphere envelope volume within which it can be enclosed. In one embodiment of the invention, the particles have an envelope mass density of less than about 0.4 g/cm3.
Aerodynamically light particles have a preferred size, e.g., a volume median geometric diameter (VMGD) of at least about 5 microns (xcexcm). In one embodiment, the VMGD is from about 5 xcexcm to about 30 xcexcm. In another embodiment of the invention, the particles have a VMGD of at least 9 xcexcm. In other embodiments, the particles have a median diameter, mass median diameter (MMD), a mass median envelope diameter (MMED) or a mass median geometric diameter (MMGD) of at least 5 xcexcm, for example from about 5 xcexcm and about 30 xcexcm.
The diameter of the particles, for example, their MMGD or their VMGD, can be measured using an electrical zone sensing instrument such as a Multisizer IIe, (Coulter Electronic, Luton, Beds, England), or a laser diffraction instrument (for example Helos, manufactured by Sympatec, Princeton, N.J.). Other instruments for measuring particle diameter are well known in the art. The diameter of particles in a sample will range depending upon factors such as particle composition and methods of synthesis. The distribution of size of particles in a sample can be selected to permit optimal deposition within targeted sites within the respiratory tract.
Aerodynamically light particles preferably have xe2x80x9cmass median aerodynamic diameterxe2x80x9d (MMAD), also referred to herein as xe2x80x9caerodynamic diameterxe2x80x9d, between about 1 xcexcm and about 5 xcexcm. In one embodiment of the invention, the MMAD is between about 1 xcexcm and about 3 xcexcm. In another embodiment, the MMAD is between about 3 xcexcm and about 5 xcexcm.
Experimentally, aerodynamic diameter can be determined by employing a gravitational settling method, whereby the time for an ensemble of particles to settle a certain distance is used to infer directly the aerodynamic diameter of the particles. An indirect method for measuring the mass median aerodynamic diameter (MMAD) is the multi-stage liquid impinger (MSLI).
The aerodynamic diameter, daer, can be calculated from the equation:
daer=dgxcfx81tap
where dg is the geometric diameter, for example the MMGD and xcfx81 is the powder density.
Particles which have a tap density less than about 0.4 g/cm3, median diameters of at least about 5 xcexcm, and an aerodynamic diameter of between about 1 xcexcm and about 5 xcexcm, preferably between about 1 xcexcm and about 3 xcexcm, are more capable of escaping inertial and gravitational deposition in the oropharyngeal region, and are targeted to the airways or the deep lung. The use of larger, more porous particles is advantageous since they are able to aerosolize more efficiently than smaller, denser aerosol particles such as those currently used for inhalation therapies.
In comparison to smaller particles the larger aerodynamically light particles, preferably having a VMGD of at least about 5 xcexcm, also can potentially more successfully avoid phagocytic engulfment by alveolar macrophages and clearance from the lungs, due to size exclusion of the particles from the phagocytes"" cytosolic space. Phagocytosis of particles by alveolar macrophages diminishes precipitously as particle diameter increases beyond about 3 xcexcm. Kawaguchi, H., et al., Biomaterials 7: 6166 (1986); Krenis, L. J. and Strauss, B., Proc. Soc. Exp. Med., 107: 748-750 (1961); and Rudt, S. and Muller, R. H., J. Contr. Rel., 22; 263-272 (1992). For particles of statistically isotropic shape, such as spheres with rough surfaces, the particle envelope volume is approximately equivalent to the volume of cytosolic space required within a macrophage for complete particle phagocytosis.
The particles may be fabricated with the appropriate material, surface roughness, diameter and tap density for localized delivery to selected regions of the respiratory tract such as the deep lung or upper or central airways. For example, higher density or larger particles may be used for upper airway delivery, or a mixture of varying sized particles in a sample, provided with the same or different therapeutic agent may be administered to target different regions of the lung in one administration. Particles having an aerodynamic diameter ranging from about 3 to about 5 xcexcm are preferred for delivery to the central and upper airways. Particles having an aerodynamic diameter ranging from about 1 to about 3 xcexcm are preferred for delivery to the deep lung.
Inertial impaction and gravitational settling of aerosols are predominant deposition mechanisms in the airways and acini of the lungs during normal breathing conditions. Edwards, D. A., J. Aerosol Sci., 26: 293-317 (1995). The importance of both deposition mechanisms increases in proportion to the mass of aerosols and not to particle (or envelope) volume. Since the site of aerosol deposition in the lungs is determined by the mass of the aerosol (at least for particles of mean aerodynamic diameter greater than approximately 1 xcexcm), diminishing the tap density by increasing particle surface irregularities and particle porosity permits the delivery of larger particle envelope volumes into the lungs, all other physical parameters being equal.
The low tap density particles have a small aerodynamic diameter in comparison to the actual envelope sphere diameter. The aerodynamic diameter, daer, is related to the envelope sphere diameter, d (Gonda, I., xe2x80x9cPhysico-chemical principles in aerosol delivery,xe2x80x9d in Topics in Pharmaceutical Sciences 1991 (eds. D. J. A. Crommelin and K. K. Midha), pp. 95-117, Stuttgart: Medpharm Scientific Publishers, 1992)), by the formula:
daer=dxcfx81
where the envelope mass xcfx81 is in units of g/cm3. Maximal deposition of monodispersed aerosol particles in the alveolar region of the human lung (xcx9c60%) occurs for an aerodynamic diameter of approximately daer=3 xcexcm. Heyder, J. et al., J. Aerosol Sci., 17: 811-825 (1986). Due to their small envelope mass density, the actual diameter d of aerodynamically light particles comprising a monodisperse inhaled powder that will exhibit maximum deep-lung deposition is:
d=3/xcfx81 xcexcm(where xcfx81 less than 1 g/cm3);
where d is always greater than 3 xcexcm. For example, aerodynamically light particles that display an envelope mass density, xcfx81=0.1 g/cm3, will exhibit a maximum deposition for particles having envelope diameters as large as 9.5 xcexcm. The increased particle size diminishes interparticle adhesion forces. Visser, J., Powder Technology, 58: 1-10. Thus, large particle size increases efficiency of aerosolization to the deep lung for particles of low envelope mass density, in addition to contributing to lower phagocytic losses.
The aerodyanamic diameter can be calculated to provide for maximum deposition within the lungs, previously achieved by the use of very small particles of less than about five microns in diameter, preferably between about one and about three microns, which are then subject to phagocytosis. Selection of particles which have a larger diameter, but which are sufficiently light (hence the characterization xe2x80x9caerodynamically lightxe2x80x9d), results in an equivalent delivery to the lungs, but the larger size particles are not phagocytosed. Improved delivery can be obtained by using particles with a rough or uneven surface relative to those with a smooth surface.
In another embodiment of the invention, the particles have an envelope mass density, also referred to herein as xe2x80x9cmass densityxe2x80x9d of less than about 0.4 g/cm3. Particles also having a mean diameter of between about 5 xcexcm and about 30 xcexcm are preferred. Mass density and the relationship between mass density, mean diameter and aerodynamic diameter are discussed in U.S. application Ser. No. 08/655,570, filed on May 24, 1996, which is incorporated herein by reference in its entirety. In a preferred embodiment, the aerodynamic diameter of particles having a mass density less than about 0.4 g/cm3 and a mean diameter of between about 5 xcexcm and about 30 xcexcm is between about 1 xcexcm and about 5 xcexcm.
Suitable particles can be fabricated or separated, for example by filtration or centrifugation, to provide a particle sample with a preselected size distribution. For example, greater than about 30%, 50%, 70%, or 80% of the particles in a sample can have a diameter within a selected range of at least about 5 xcexcm. The selected range within which a certain percentage of the particles must fall may be for example, between about 5 and about 30 xcexcm, or optimally between about 5 and about 15 xcexcm. In one preferred embodiment, at least a portion of the particles have a diameter between about 9 and about 11 xcexcm. Optionally, the particle sample also can be fabricated wherein at least about 90%, or optionally about 95% or about 99%, have a diameter within the selected range. The presence of the higher proportion of the aerodynamically light, larger diameter particles in the particle sample enhances the delivery of therapeutic or diagnostic agents incorporated therein to the deep lung. Large diameter particles generally mean particles having a median geometric diameter of at least about 5 xcexcm.
The invention also relates to methods of preparing particles having a tap density less than about 0.4 g/cm3. In one embodiment, the method includes spray drying a mixture, also referred to herein as a xe2x80x9cfeed solutionxe2x80x9d, xe2x80x9cfeed suspensionxe2x80x9d, or xe2x80x9cfeed colloidal suspensionxe2x80x9d which includes a carboxylic acid or salt thereof, a phospholipid or combination of phospholipids, a multivalent salt and a solvent. In one embodiment, the mixture also includes a therapeutic, prophylactic or diagnostic agent.
Suitable carboxylic acids or salts thereof include, but are not limited to those described above. The amount of carboxylic acid or salt thereof present in the mixture ranges from about 10 to about 80% weight. The phospholipid or mixture of phospholipids includes, for example, the phospholipids described above. The amount of phospholipid present in the mixture ranges from about 20 to about 90% weight. The multivalent salt includes but is not limited to the multivalent salts described above. The amount of multivalent salt present in the mixture ranges from about 5 to about 40% weight. The therapeutic, prophylactic or diagnostic agent includes but is not limited to the therapeutic, prophylactic or diagnostic agents described above. The amount of therapeutic, prophylactic or diagnostic agent present in the mixture ranges from about less than 1% to about 40% weight.
Suitable organic solvents that can be employed include but are not limited to alcohols such as, for example, ethanol, methanol, propanol, isopropanol, butanols, and others. Other organic solvents include but are not limited to perfluorocarbons, dichloromethane, chloroform, ether, ethyl acetate, methyl tert-butyl ether and others. Co-solvents that can be employed include an aqueous solvent and an organic solvent, such as, but not limited to, the organic solvents as described above. Aqueous solvents include, for example, water and buffered salts. In a preferred embodiment, the co-solvent includes about 70/30 ethanol/water by volume. In another preferred embodiment, the co-solvent includes from about 60/40 to about 85/15 ethanol/water.
In a preferred embodiment the mixture includes a colloidal solution or colloidal suspension. As used herein, the terms xe2x80x9ccolloidal solutionxe2x80x9d or xe2x80x9ccolloidal suspensionxe2x80x9d refer to a system intermediate between a true solution and a suspension; the dispersed phase of the colloidal solution or suspension have a particle size ranging from about 1 and 500 nanometers.
In one embodiment of the invention, the mixture is prepared by solubilizing a phospholipid in an organic solvent, such as, for example ethanol, and a carboxylic acid or salt thereof in an aqueous solvent. The two phases are combined and a multivalent salt, such as, for example, calcium chloride is added thereby forming a fine suspension or colloidal solution.
The mixture can have a neutral, acidic or alkaline pH. Optionally, a pH buffer can be added to the solvent or co-solvent or to the formed mixture. Preferably, the pH can range from about 3 to about 10. In one embodiment, the mixture is a miscible mixture of organic and aqueous phases.
Suitable spray-drying techniques are described, for example, by K. Masters in xe2x80x9cSpray Drying Handbookxe2x80x9d, John Wiley and Sons, New York, 1984. Generally, during spray-drying, heat from a hot gas such as heated air or nitrogen is used to evaporate the solvent from droplets formed by atomizing a continuous liquid feed. Other spray-drying techniques are well known to those skilled in the art. In a preferred embodiment, a rotary atomizer is employed. An examples of suitable spray driers using rotary atomization includes the Mobile Minor spray drier, manufactured by Niro, Denmark. The hot gas can be, for example, air, nitrogen or argon.
Preferably, the particles of the invention are obtained by spray drying using an inlet temperature between about 100xc2x0 C. and about 400xc2x0 C. and an outlet temperature between about 50xc2x0 C. and about 130xc2x0 C.
Without being held to any mechanistic interpretation of the invention, it is believed that the formation of a colloidal solution facilitates shell formation by (i) providing nucleation sites for the shell to form and (ii) slowing down the diffusion rates of the excipients in the drying droplet, it is also believed that the presence of the carboxylate moiety and calcium alters the phase behavior of the phospholipid in solution to create a colloidal aggregate phase that facilitates shell formation.
The spray dried particles can be fabricated with a rough surface texture to reduce particle agglomeration and improve flowability of the powder. The spray-dried particle can be fabricated with features which enhance aerosolization via dry powder inhaler devices, and lead to lower deposition in the mouth, throat and inhaler device.
Particles including a medicament, for example one or more of the drugs listed above, are administered to the respiratory tract of a patient in need of treatment, prophylaxis or diagnosis. Administration of particles to the respiratory system can be by means such as known in the art. For example, particles are delivered from an inhalation device. In a preferred embodiment, particles are administered via a dry powder inhaler (DPI). Metered-dose-inhalers (MDI), nebulizers or instillation techniques also can be employed.
Various suitable devices and methods of inhalation which can be used to administer particles to a patient""s respiratory tract are known in the art. For example, suitable inhalers are described in U.S. Pat. No. 4,069,819, issued Aug. 5, 1976 to Valentini, et al., U.S. Pat. No. 4,995,385 issued Feb. 26, 1991 to Valentini, et al., and U.S. Pat. No. 5,997,848 issued Dec. 7, 1999 to Patton, et al. Other examples include, but are not limited to, the Spinhaler(copyright) (Fisons, Loughborough, U.K.), Rotahaler(copyright) (Glaxo-Wellcome, Research Triangle Technology Park, North Carolina), FlowCaps(copyright) (Hovione, Loures, Portugal), Inhalator(copyright) (Boehringer-Ingelheim, Germany), and the Aerolizer(copyright) (Novartis, Switzerland), the diskhaler (Glaxo-Wellcome, RTP, NC) and others, such as known to those skilled in the art. Preferably, the particles are administered as a dry powder via a dry powder inhaler.
The particles of the invention can be employed in compositions suitable for drug delivery to the pulmonary system. For example, such compositions-can include the particles and a pharmaceutically acceptable carrier for administration to a patient, preferably for administration via inhalation. The particles can be co-delivered with larger carrier particles, not including a therapeutic agent, the latter possessing mass median diameters for example in the range between about 50 xcexcm and about 100 xcexcm. The particles can be administered alone or in any appropriate pharmaceutically acceptable carrier, such as a liquid, for example saline, or a powder, for administration to the respiratory system.
The invention is also related to a method for drug delivery to the pulmonary system. The method comprises administering to the respiratory tract of a patient in need of treatment, prophylaxis or diagnosis an effective amount of particles, such as described above, comprising a therapeutic, prophylactic or diagnostic agent. As used herein, the term xe2x80x9ceffective amountxe2x80x9d means an amount required to achieve a desired effect, such as, for example, desired therapeutic response, or efficacy. The actual effective amounts of drug can vary according to the specific drug or combination thereof being utilized, the particular composition formulated, the mode of administration, and the age, weight, condition of the patient, and severity of the symptoms or condition being treated. Dosages for a particular patient can be determined by one of ordinary skill in the art using conventional considerations, (e.g. by means of an appropriate, conventional pharmacological protocol).
Aerosol dosage, formulations and delivery systems also may be selected for a particular therapeutic application, as described, for example, in Gonda, I. xe2x80x9cAerosols for delivery of therapeutic and diagnostic agents to the respiratory tract,xe2x80x9d in Critical Reviews in Therapeutic Drug Carrier Systems, 6: 273-313, 1990; and in Moren, xe2x80x9cAerosol dosage forms and formulations,xe2x80x9d in: Aerosols in Medicine. Principles, Diagnosis and Therapy, Moren, et al., Eds, Esevier, Amsterdam, 1985.
Preferably, particles administered to the respiratory tract travel through the upper airways (oropharynx and larynx), the lower airways which include the trachea followed by bifurcations into the bronchi and bronchioli and through the terminal bronchioli which in turn divide into respiratory bronchioli leading then to the ultimate respiratory zone, the alveoli or the deep lung. In a preferred embodiment of the invention, most of the mass of particles deposits in the deep lung. In another embodiments of the invention, delivery is primarily to the central airways. Delivery to the upper airways can also be obtained.
In one embodiment of the invention, delivery to the pulmonary system of particles is in a single, breath-actuated step, as described in U.S. Patent Application, High Efficient Delivery of a Large Therapeutic Mass Aerosol, application Ser. No. 09/591,307, filed Jun. 9, 2000, which is incorporated herein by reference in its entirety. In another embodiment of the invention, at least 50% of the mass of the particles stored in the inhaler receptacle is delivered to a subject""s respiratory system in a single, breath-activated step. In a further embodiment, at least 5 milligrams and preferably at least 10 milligrams of a medicament is delivered by administering, in a single breath, to a subject""s respiratory tract particles enclosed in the receptacle. Amounts as high as 15, 20, 25, 30, 35, 40 and 50 milligrams can be delivered.
Porous or aerodynamically light particles, having a geometric size (or mean diameter) in the range of about 5 to about 30 xcexcm, and tap density less than about 0.4 g/cm3, such that they possess an aerodynamic diameter of about 1 and about 3 xcexcm, have been shown to display ideal properties for delivery to the deep lung. Larger aerodynamic diameters, ranging, for example, from about 3 to about 5 xcexcm are preferred, however, for delivery to the central and upper airways. According to one embodiment of the invention the particles have a tap density of less than about 0.4 g/cm3 and a mean diameter of between about 5 xcexcm and about 30 xcexcm. According to another embodiment of the invention, the particles have a mass density of less than about 0.4 g/cm3 and a mean diameter of between about 5 xcexcm and about 30 xcexcm. In one embodiment of the invention, the particles have an aerodynamic diameter between about 1 xcexcm and about 5 xcexcm. In another embodiment of the invention, the particles have an aerodynamic diameter between about 1 xcexcm and about 3 xcexcm microns. In still another embodiment of the invention, the particles have an aerodynamic diameter between about 3 xcexcm and about 5 xcexcm.
In one embodiment of the invention, the particles are administered to the respiratory system of a comatose, unconscious or anesthetized patient. In another embodiment, the particles are administered to the respiratory system of a nonhuman mammal, for example in veterinary medicine or animal model experimental work. In a further embodiment of the invention, the particles are administered to sites other than the pulmonary system.